    <div class="container margin-top-content">
      <div class="row">
        <div class="col-md-10 col-md-offset-1">
          <div class="col-md-12">
            <div class="row outer-border shadow singlepage">
              
              <div class="col-md-12 padding15">
                <h4 class="font-biru judul-singlepage">Pendaftaran Magang</h4>
                <form action="<?php echo site_url('proses-daftar'); ?>" method="post" class="form-horizontal small" role="form">
                  <div class="form-group">
                    <label class="col-sm-4 control-label">Nama Sekolah/Perguruan Tinggi</label>
                    <div class="col-sm-7">
                      <input type="text" name="nm_pegawai" class="form-control input-sm" placeholder="Nama Sekolah/Perguruan Tinggi">
                    </div>
                  </div>
            
                  <div class="form-group">
                    <label class="col-sm-4 control-label">Nama Penanggungjawab</label>
                    <div class="col-sm-7">
                        <input type="text" name="nm_pegawai" class="form-control input-sm" placeholder="Nama Penanggungjawab">
                    </div>
                  </div>

                  <div class="form-group">
                    <label class="col-sm-4 control-label">Jumlah Siswa Magang</label>
                    <div class="col-sm-7">
                        <input type="text" name="nm_pegawai" class="form-control input-sm" placeholder="Jumlah Siswa Magang">
                    </div>
                  </div>

                  <div class="form-group">
                    <label class="col-sm-4 control-label">Bidang Studi</label>
                    <div class="col-sm-7">
                        <input type="text" name="nm_pegawai" class="form-control input-sm" placeholder="Bidang Studi">
                    </div>
                  </div>

                  <div class="form-group">
                    <label class="col-sm-4 control-label">Waktu Magang</label>
                    <div class="col-sm-3">
                      <input type="text" name="tgl_mulai" value="<?php echo date('d/m/Y') ?>" class="form-control input-sm tanggal">
                    </div>
                    <div class="col-sm-1" style="padding-top: 6px;">Sampai</div>
                    <div class="col-sm-3">
                      <input type="text" name="tgl_selesai" value="<?php echo date('d/m/Y') ?>" class="form-control input-sm tanggal">
                    </div>
                  </div>
                  <div class="form-group">
                    <label class="col-sm-4 control-label">Catatan</label>
                    <div class="col-sm-7">
                      <textarea name="alamat" class="form-control input-sm" rows="3" placeholder="Catatan"></textarea>
                    </div>
                  </div>
            
                  <div class="form-group">
                    <div class="col-sm-offset-4 col-sm-7">
                      <button type="submit" class="btn btn-primary btn-sm">Daftar</button>
                      <button type="reset" class="btn btn-danger btn-sm">Reset</button>
                    </div>
                  </div>
                </form>
              </div>
            <div class="clearfix"></div>
            </div>
          </div>
        <div class="clearfix"></div>
        </div>
      </div>
    </div><!-- /.container -->